Cervical exams are performed in adult women to detect problems, such as cancer, before any symptoms are evident. Such exams are performed by a doctor, with a nurse in attendance. The patient's legs are spread and elevated on stirrups, and internal inspection requires a light source and a metal or plastic speculum. The speculum spreads the walls of the vagina so that the inside may be observed. A Pap smear is also performed through the speculum, with a stick similar to a tongue depressor, and sometimes a culture is taken with a cotton swab. Should any abnormalities be detected, such as chronic cervicitis or cervical polyps, a colposcope or colpumiroscope is used to do a more thorough examination.
The physical position that the patient must assume can be uncomfortable and somewhat embarrassing. This may cause tension at a time when it is necessary for the patient to relax her vaginal muscles. Also, the doctor must put his or her face close to the vagina to view through the speculum. One must question the effectiveness of such an exam since its comparable to looking into a tunnel with a flashlight.
A more detailed exam can be done with a colposcope, which is similar to a small microscope with a swing arm. The scope section is inserted into the vagina for a detailed look. This procedure, colposcopy, is only a live view, without any effective method of documenting or reviewing what has been observed.